The spectrum of post-myocardial infarction care: From acute ischemia to heart failure

Prog Cardiovasc Dis. 2024 Jan-Feb:82:15-25. doi: 10.1016/j.pcad.2024.01.017. Epub 2024 Jan 17.


Heart failure (HF) is the leading cause of mortality in patients with acute myocardial infarction (AMI), with incidence ranging from 14% to 36% in patients admitted due to AMI. HF post-MI develops due to complex inter-play between macrovascular obstruction, microvascular dysfunction, myocardial stunning and remodeling, inflammation, and neuro-hormonal activation. Cardiogenic shock is an extreme presentation of HF post-MI and is associated with a high mortality. Early revascularization is the only therapy shown to improve survival in patients with cardiogenic shock. Treatment of HF post-MI requires prompt recognition and timely introduction of guideline-directed therapies to improve mortality and morbidity. This article aims to provide an up-to-date review on the incidence and pathogenesis of HF post-MI, current strategies to prevent and treat onset of HF post-MI, promising therapeutic strategies, and knowledge gaps in the field.

Keywords: Cardiogenic shock; Heart failure; Mechanical circulatory support; Medical therapy; Myocardial infarction; Revascularization; STEMI.

Publication types

  • Review

MeSH terms

  • Heart Failure* / diagnosis
  • Heart Failure* / epidemiology
  • Heart Failure* / therapy
  • Humans
  • Myocardial Infarction* / complications
  • Myocardial Infarction* / diagnosis
  • Myocardial Infarction* / therapy
  • Shock, Cardiogenic / diagnosis
  • Shock, Cardiogenic / etiology
  • Shock, Cardiogenic / therapy